Is it Ethical to Refuse to Treat a Patient due to Sexual Identity?

The constant debate over the rights of those who identify with a particular sexual identity seems never-ending. How does it affect nursing? How does the new proposed bill in Michigan make the situation change? Find out the facts before forming an opinion.

Patients come in all sorts of flavors. You have your frequent flyers, your noncompliants, your criminals, and your sweet little senior citizens. All patients are different, and this is part of the joy of nursing. Everyone has their own story, and we get to listen to them, help them, and see them flourish. While not everyone agrees with it, patients come in all kinds of sexual orientations, too. You can have those who are gay, bisexual, transexual, or transvestites. Just a normal day on the job for a nurse, right?

Sexual identity is a hot button issue, and it is becoming hotter. The internet almost blew up a few weeks ago about a Michigan law that purported to allow EMS personnel to deny treatment to patients who identified with a particular sexual identity. Supposedly, this bill allowed medical personnel to refuse based on religious beliefs. You can't believe everything you read on the internet, folks, and there is more to this story than meets the eye. It still brings up the ethical question: can medical workers refuse to treat those who violate a strongly held religious belief?

What the Michigan Bill Says

The bill currently under consideration in Michigan is called the Religious Freedom and Restoration Act, or RFRA. It is currently in the Michigan house, where it was proposed, and still has to work through the system and be signed by the government before it is law. Therefore, the RFRA is not a law in Michigan, despite what the internet says. It is a long, long way from that, and it could change drastically as the politicians get their hands on it. No need to worry, really. It's just an idea at this point.

Another crucial bit to understand is that the bill does not specifically give medical personnel the right to refuse treatment to gay people. The bill doesn't mention medicine or homosexuals at all. Instead, the bill suggests that a person who is by law required to act can choose not to act due to a strongly held religious belief. This means that it could be used as a defense in court if the one who should act is sued by the one not acted upon. Mostly, this would entail civil cases, but this isn't where the story ends.

Possible Scenarios Arising from the Bill

As most lawyers do, far more has been read into this bill than originally intended. Opponents of the bill have suggested that this law could be applied to medical personnel, from doctors to nurses to EMTs. In fact, it could affect any person required by law to act, and they would be in their rights to refuse. Please note, this is not what the bill says, but it is merely a possibility that could be read into the law to protect a medical professional who didn't act when they were required to.

It also brings up the idea of religious freedom. If you know that someone is gay and you disagree with that, do you have to act? The proposed law technically says no. When you hold a sincere and strong religious belief about something, the state cannot force you to act against those beliefs -- even if it means that someone else suffers because of it. This is a bit about the separation of church and state in addition to medicine. How far do religious beliefs go? Can you refuse someone anything because they don't agree with your religious point of view? For instance, should you be forced to rent your property to someone who is gay? According to this law, you wouldn't have to, and that would get you out of a discrimination suit.

Should Healthcare Workers have the Right to Refuse Treatment?

Despite the fact that this bill is far from a law and despite the fact that it doesn't directly affect medical workers, it does bring up a disturbing question: do nurses have the right to refuse to treat patients who are gay? Look at it this way: Do we have the right to refuse treatment of someone with HIV or Ebola? Do we have the right to refuse treatment of a patient whose religion is different than ours? Do we have the right to refuse treatment to those who have a violent criminal past? I have taken care of child molesters, rapists, and murders. I certainly don't agree with their actions, but I took care of them to the best of my ability.

Why is it different for someone of a different sexual orientation? It all boils down to the patient. Here is someone sick in front of you. Does it matter how they have sex? Does it matter what they believe? Do you have the right to play God and decide who lives and who dies? No matter who our patients are, I believe that we have the legal and ethical responsibility to care for them to their last breath. We didn't come into nursing to pick and choose those that we will care for, and politics does not belong at the patient's bedside. Instead, nurses should care for who they are charged with -- criminal, homosexual, black, white, Islamic, or whatever. No one should be denied care, and that includes the modern day lepers, those with a different sexual identity.

References

Michigan House Bill No. 5958; Accessed January 9, 2015

http://www.legislature.mi.gov/documents/2013-2014/billengrossed/House/pdf/2014-HEBH-5958.pdf

Snopes; Slake Michigan; Accessed January 9, 2015

snopes.com: Michigan Exempts Emergency Medical Personnel from Treating Gay People?

Specializes in Critical Care and ED.
It's being reported this AM that the Trump administration is going to announce today that it is creating a new office with the DHHS to proect the rights of healthcare professionals to practice their faith without being penalized -- the point of this office is to expand the protections that already exist for healthcare professionals to decline to participate in procedures they object to on religious grounds, and expand that kind of protection to any kind of moral or religious objection to providing treatment, e.g., refusing to treat gay or transgendered individuals because you disapprove of them on moral or religious grounds.

New HHS civil rights division to shield health workers with moral or religious objections - The Washington Post

This makes me absolutely rageful. I hope that sensible minded people come out in droves to protest this backwards stance. I can see lots of lawsuits coming.

Specializes in Critical care.
It's being reported this AM that the Trump administration is going to announce today that it is creating a new office with the DHHS to proect the rights of healthcare professionals to practice their faith without being penalized -- the point of this office is to expand the protections that already exist for healthcare professionals to decline to participate in procedures they object to on religious grounds, and expand that kind of protection to any kind of moral or religious objection to providing treatment, e.g., refusing to treat gay or transgendered individuals because you disapprove of them on moral or religious grounds.

New HHS civil rights division to shield health workers with moral or religious objections - The Washington Post

This is something I hope the BON can still do something about. Absolutely disgraceful. It's none of my business what someone does in their personal life-I treat all my patients the same. I've had police on the unit for a new admit and I made it clear I'd speak with them AFTER I got the patient stabilized and comfortable.

This makes me absolutely rageful. I hope that sensible minded people come out in droves to protest this backwards stance. I can see lots of lawsuits coming.

This is something I hope the BON can still do something about. Absolutely disgraceful. It's none of my business what someone does in their personal life-I treat all my patients the same. I've had police on the unit for a new admit and I made it clear I'd speak with them AFTER I got the patient stabilized and comfortable.

Yeah, but this kind of thing is exactly what the Trump voters were voting for, and all that matters to this administration is keeping them happy.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
This makes me absolutely rageful. I hope that sensible minded people come out in droves to protest this backwards stance. I can see lots of lawsuits coming.

Are there sensible people in the Trump administration?

Are there sensible people in the Trump administration?

I believe that compassionate people exist in spite of Trump administration. In fact, I am grateful that Trump is still the president. Can you imagine what will happen when Mike Pence becomes a president?

I am religious, but I will never side with Christians and Muslims about anything in our society.

Statistics show that American people trust atheist the least. Luckily, I am a naturalized citizen. I wasn't born here. I have not been saturated with Christian thinking. Otherwise, American society would have another bigot since I am a stubborn person. When it comes to compassion and justice, I make no apology about my conviction. Most people who profess their atheism to me are among the most wonderful people I have ever met. I will vote for one as our president over a Christian. I am sure that he/she will use his/her humanistic rationality to eradicate religious discrimination in the most efficient way.

Having said that, if this bill really supports refusal to treat lgbt people due to religious conscience, I think people should let it fly. I say this as a gay person. When I am sick, the only thing that I am able to control is my dignity, how I feel about myself. I would dehumanize myself when I allow a Christian, who sincerely believes that what makes me who I am is an abomination, to take care of me. Do I really want that?

I grew up in a communist country. Coming to the US, I understand what human worth and dignity are. In my opinion, Christianity is a disgrace to humanity. People who follow a god who is willing to make anyone who is not convinced of his existence suffer for eternity should only take care of people of their kind. I believe that when those people are screened out, compassionate nurses will shine. We need nurses who accept patients for who they are. We don't need nurses who tolerate patients for their identity.

I don't think we can ever legislate morality. I personally don't want that. I always admire nurses for their dedication, compassion, and empathy. I don't believe that Christian nurses are capable of these characters. If they are, they simply take care of patients to serve a religious ideology, i.e., to spread their faith. They don't do it for patients.

Therefore, forcing them through laws to care for "sinners" is asking them to carry a burden on themselves. If they cannot leave their nursing profession, let them do their job with their own kind so that they can leave non Christians alone.

I think we should have greater trust on American people. From my experience as an immigrant, a majority of Americans are very accepting of people who don't practice Christianity, people who are gay, people who are not Caucasians. I trust that they would make the right decision in terms of morality. Christian bigots who happen to be nurses will fade out of their profession when no patient wants their care. People's sense of justice will eliminate these bigots naturally.

When you look at senator Mark Kirk, you can see that he changed his view about gay marriage after he recovered from stroke. Until Christians suffer like they make non believers suffer, they will not understand the type of pain they cause on other people.

I think this bill will be a great opportunity to allow people who have moral conflict with Christian values not to take care of Christians. Let them have their own medicine for once and see how much longer they can use their faith to justify their imposition on non Christians.